阻塞性睡眠呼吸暂停低通气综合征患儿手术前后血尿酸变化  

Changes of Blood Uric Acid Before and After Operation in Children with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：刘明秋[1,2] 毕京玉[1,2] 万京明[1,2] 

机构地区：[1]山东省莱芜市人民医院 [2]泰山医学院附属莱芜医院耳鼻喉科,山东莱芜271100

出　　处：《武汉大学学报（医学版）》2013年第5期733-736,共4页Medical Journal of Wuhan University

基　　金：山东省星火计划资助项目(编号:2008XH060)

摘　　要：目的:分析儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术前后血尿酸(UA)的变化,探讨血尿酸在儿童OSAHS的诊断与治疗中的临床价值。方法:98例患儿经多导睡眠监测(PSG)确诊,具备腺样体和(或)扁桃体切除手术指征,根据睡眠呼吸暂停低通气指数(AHI)分为3组:轻度组32例(5≤AHI<10),中度组41例(10≤AHI<20),重度组25例(AHI≥20),各组于术前及术后6个月清晨抽取肘静脉血液标本测定血UA水平,另选择健康儿童体检者35例作为对照组。结果:术前各组AHI、最低血氧饱和度(LSaO2)与健康对照组之间的差异均有统计学意义(P<0.05);轻度组术前UA与健康对照组之间的差异无统计学意义(P>0.05),中、重度组术前UA显著增高,与健康对照组及轻度组之间的差异有统计学意义(P<0.05)。术后各组AHI、LSaO2、UA与健康对照组相比,差异均无统计学意义(P>0.05);与术前相比,除轻度组UA外,差异均有统计学意义(P<0.05)。UA水平与AHI呈正相关(r=0.25,P<0.05),与LSaO2呈负相关(r=-0.42,P<0.05)。结论:中重度儿童OSAHS患者UA水平显著增高,手术治疗后UA降至健康儿童水平,因此UA可作为儿童OSAHS诊断与治疗的临床参考指标。Objective： To analyze the changes of blood uric acid （UA） before and after operation and to investigate clinical value of UA in children with obstructive sleep apnea hypopnea syndrome （OS- AHS）. Methods： A total of 98 children with OSAHS diagnosed by polysomnography （PSG） had indications of adenotonsillectomy. According to apnea hypopnea index （AHI）, all cases were di- vided into three groups as： mild group （5≤AHI〈10, n=32）, moderate group （10≤AHI〈20, n =41）, and severe group （AHI≥20, n=25）. The levels of blood UA were determined before and 6 months after operation. Thirty-five normal children for physical examination were served as control group. Results： There were statistical significances in AHI and lowest arterial oxygen sat- uration （LSaO2） between each preoperative group and control group（P〈0.05）. The difference ofUA was not statistically significant between mild group before operation and control group（P〉0.05）, but it was significant between moderate/severe group and mild/control group （P〈0.05）. There were no statistical significances in AHI, LSaO2, and UA between each postoperative group and control group（P〉0.05）. Except for UA of mild group （P〈0.05）, AHI, LSaO2 and UA changed significantly after operation （P〈0.05）. The level of UA had a positive correlation with AHI （r=0.25, P〈0.05） and a negative correlation with LSaO2 （r=--0.42, P〈0.05）. Conclu- sion. The level of UA increases significantly in children with moderate and severe OSAHS, and decreases to normal after and treatment of children adenotonsillectomy. UA can be used as a clinical marker in diagnosis with OSAHS.

关 键 词：睡眠呼吸暂停 阻塞性 尿酸 儿童 

分 类 号：R766[医药卫生—耳鼻咽喉科]